CPT® Code 61460

CPT® Code 61460 refers to a surgical procedure known as a suboccipital craniectomy, which involves the sectioning, or cutting, of one or more cranial nerves. This procedure is typically indicated when cranial nerves are compressed due to the presence of blood vessels that cross over them, leading to various neurological symptoms. The compression of these nerves can result in conditions such as vertigo, which is a sensation of dizziness often associated with the vestibular nerve, or tinnitus, characterized by ringing or other auditory disturbances linked to the cochlear nerve. During the procedure, the patient is positioned supine, and their head is stabilized using a Mayfield clamp. The surgical approach involves making a curvilinear incision behind the ear while carefully avoiding damage to the greater and lesser occipital nerves. A small section of the skull is then removed to access the underlying structures. The dura mater, a protective membrane covering the brain, is incised, allowing for decompression of the posterior fossa and exposure of the cerebellopontine angle. This area is critical for accessing the cranial nerves. The procedure may involve microvascular decompression techniques, where synthetic sponges are placed to alleviate pressure from blood vessels on the nerves. However, in the case of CPT® Code 61460, the focus is on the sectioning of the cranial nerves themselves, which is performed to alleviate severe symptoms associated with conditions like Meniere's disease or vestibular neuritis. After the surgical intervention, the dura is reapproximated, and the exposed mastoid air cells are sealed with bone wax to prevent complications. The surgical site is then closed in layers using Gelfoam, Gelfilm, muscle, fascia, and skin, ensuring proper healing and recovery.